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Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

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Outline

Threatened/Spontaneous Abortion

Definition/Etiology:

Threatened abortion occurs when a pregnant patient less than 20 weeks’ gestation has vaginal bleeding. Usually due to a chromosomal abnormality.
In a spontaneous abortion, the cervical os is open, products of conception may be expelled or there may be no fetal heartbeat.

Pathophysiology:

Threatened abortion: The cervical os remains closed and therefore does not meet criteria for a spontaneous abortion. More than half of all threatened abortions will eventually abort.
Spontaneous abortion – cervical os is open and fetus/products of conception may be expelled.

Clinical Presentation:

Vaginal bleeding
Abdominal Pain/cramping
Positive pregnancy test/ beta hCG

Collaborative Management:

Ultrasound
Determine fetal cardiac activity
Beta hCG to ensure appropriate progression
CBC to ensure there is no elevated WBC
Type and Screen
D&C may be needed with a spontaneous abortion that has not fully evacuated
Pitocin may be used if incomplete abortion. Antibiotics may be used in the case of septic abortion

Evaluation | Patient Monitoring | Education:

Avoid strenuous activity
- Pelvic rest
Bed rest has not been found to prevent a threatened abortion from progressing towards a spontaneous abortion, so it is usually not recommended

Linchpins: (Key Points)

Threatened abortion is the chance of an abortion due to vaginal bleeding but is not actually aborting at this point
Spontaneous abortion =unviable pregnancy.
Monitor for sepsis
Don’t forget the RhoGAM!

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Threatened miscarriage – sandwell and West Birmingham NHS Trust. (2014). Retrieved October 14, 2022, from https://www.swbh.nhs.uk/wp-content/uploads/2012/07/Threatened-miscarriage-ML4609.pdf
Mouri, M., Hall, H., & Rupp, T. J. (2021). Threatened abortion. In StatPearls [Internet]. StatPearls Publishing.
Sheehy, S. B., Hammond, B. B., & Zimmermann, P. G. (2013). Sheehy’s manual of emergency care. 7th ed. / St. Louis, Mo., Elsevier/Mosby.

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OB

Concepts Covered:

Pregnancy Risks
Labor Complications
Newborn Complications
Fetal Development
Terminology
Prenatal Concepts
Newborn Care
Postpartum Care
Postpartum Complications
Medication Administration
Labor and Delivery
Studying
Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed

Abruptio Placentae (Placental abruption)

Acyclovir (Zovirax) Nursing Considerations

Addicted Newborn

Alpha-fetoprotein (AFP) Lab Values

Anemia in Pregnancy

Antepartum Testing

Antepartum Testing Case Study (45 min)

Betamethasone and Dexamethasone

Betamethasone and Dexamethasone in Pregnancy

Butorphanol (Stadol) Nursing Considerations

Cardiac (Heart) Disease in Pregnancy

Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)

Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)

Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)

Chorioamnionitis

Day in the Life of a Labor Nurse

Day in the Life of a Postpartum Nurse

Discomforts of Pregnancy

Disseminated Intravascular Coagulation (DIC)

Ectopic Pregnancy

Ectopic Pregnancy Case Study (30 min)

Emergent Delivery (OB) (30 min)

Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)

Erythroblastosis Fetalis

Eye Prophylaxis for Newborn

Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)

Family Planning & Contraception

Fertilization and Implantation

Fetal Alcohol Syndrome (FAS)

Fetal Circulation

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Heart Monitoring (FHM)

Fetal Environment

Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)

Fundal Height Assessment for Nurses

Gestation & Nägele’s Rule: Estimating Due Dates

Gestational Diabetes (GDM)

Gestational HTN (Hypertension)

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care

Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

Hepatitis B Vaccine for Newborns

Homocysteine (HCY) Lab Values

Hydatidiform Mole (Molar pregnancy)

Hyperemesis Gravidarum

Hypovolemic Shock Case Study (OB sim) (60 min)

Incompetent Cervix

Infections in Pregnancy

Initial Care of the Newborn (APGAR)

Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Lung Surfactant for Newborns

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meconium Aspiration

Meds for Postpartum Hemorrhage (PPH)

Menstrual Cycle

Newborn of HIV+ Mother

Newborn Physical Exam

Newborn Reflexes

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Dystocia

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Gestational Diabetes (GDM)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for Hyperemesis Gravidarum

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)

Nursing Care Plan (NCP) for Preterm Labor / Premature Labor

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Case Study for Maternal Newborn

Nutrition in Pregnancy

OB (Labor) Nurse Report to OB (Postpartum) Nurses

OB Non-Stress Test Results Nursing Mnemonic (NNN)

Obstetric Trauma for Certified Emergency Nursing (CEN)

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)

Oxytocin (Pitocin) Nursing Considerations

Pediatric Vital Signs (VS)

Phytonadione (Vitamin K) for Newborn

Placenta Previa for Certified Emergency Nursing (CEN)

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Post-Partum Assessment Nursing Mnemonic (BUBBLE)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Interventions

Postpartum Physiological Maternal Changes

Preeclampsia (45 min)

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

Pregnancy Outcomes Nursing Mnemonic (GTPAL)

Preterm Labor for Certified Emergency Nursing (CEN)

Process of Labor – Mom Nursing Mnemonic (4 P’s)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

Prolapsed Umbilical Cord

Prostaglandins in Pregnancy

Rh Immune Globulin in Pregnancy

Signs of Pregnancy (Presumptive, Probable, Positive)

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Tips & Advice for Newborns (Neonatal IV Insertion)

Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)